Preoperative hemostatic assessment: a new and simple bleeding questionnaire.

Area of Science:

• Hematology
• Surgical Risk Assessment
• Diagnostic Tool Development

Background:

• Current guidelines for perioperative bleeding risk assessment are limited.
• Coagulation testing is restricted to patients with a history of bleeding.
• A simple preoperative screening questionnaire for bleeding disorders is lacking.

Purpose of the Study:

• To assess the performance of a novel screening questionnaire, HEMSTOP, in detecting bleeding disorders.
• To evaluate HEMSTOP's ability to identify patients needing perioperative hemostatic precautions.

Main Methods:

• A seven-point questionnaire, HEMSTOP, was administered to patients referred for bleeding symptoms (n=38), those not requiring precautions (n=75), and healthy volunteers (n=70).
• Sensitivity and specificity of HEMSTOP scores were calculated.
• HEMSTOP performance was compared to standard coagulation assays (prothrombin time, activated partial thromboplastin time).

Main Results:

• Patients requiring perioperative precautions had significantly higher HEMSTOP scores (median 2) compared to those not requiring precautions (median 1) and healthy controls (median 0).
• A HEMSTOP score ≥ 2 demonstrated high specificity (98.6%) and sensitivity (89.5%) for identifying patients needing precautions.
• Standard coagulation tests had a much lower sensitivity (26.3%) compared to HEMSTOP.

Conclusions:

• The HEMSTOP score effectively differentiates patients at elevated risk for bleeding requiring perioperative precautions.
• HEMSTOP shows promise as a tool for predicting perioperative bleeding risk.
• Further evaluation is needed to confirm the definitive usefulness of the HEMSTOP score.